Introduction of the 'Blue Card' Concussion Policy to Semi-Elite Australian Football: Medical Staff Experiences and Perceptions.
Jacob R Msando, Gill Cowen, Sarah A Harris and 2 others
PMID 39628782WHAT IT FOUND
Most match-day medical staff in semi-elite Australian football did not support the 'blue-card' concussion rule, disagreeing that it helps identify concussions or assist diagnosis.
Over two-thirds recommended against its continuation, citing a need for better pre-season concussion education.
Key findings
01The majority of medical staff did not agree that the blue-card rule helps identify players with concussions or assists in making a concussion diagnosis.
02Over two-thirds of medical staff did not agree that the blue-card rule should remain within the league.
03Most respondents reported a need for the league to provide specific concussion education for medical staff.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study had a low number of WAFL-Women participants compared to WAFL-Men, limiting the generalizability of findings across genders and competitions. Response rate was 48%, which may introduce selection bias if those with strong opinions (positive or negative) were more likely to complete the survey. Data relied on self-report and recall of past events, which is subject to recall bias. The study did not measure the actual sensitivity or specificity of the blue-card rule in detecting concussions, only staff perceptions of it.
Declared interests
The authors declare no conflicts of interest. The study was conducted in partnership with the Western Australian Football Commission (WAFC), which provided participant contact details.
The easy way to misread this
Do not interpret the high rate of same-game return-to-play (69%) as evidence of poor medical judgment alone; the paper notes this occurred despite 75% of those assessed being diagnosed with concussion, highlighting a potential flaw in the protocol's enforcement or the diagnostic tools used at the time, rather than just individual clinician error.